52102_SHAVER, MICHAEL_20071130

156
❑CAMA / ❑DREDGE &FILL
is
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name `
Address
City
State
I '1
ZIP ' ; --
Phone #
fax # (�
)
Authorized Agent
i
uT ;-�_.--
�,
Affected ❑ CW
❑ EW
❑ PTA ❑ ES
❑ PTS y
AEC(s): ❑ OEA
❑ HHF
❑ IN ❑ UIBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA
yes / no
Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
/ 1
City ZIP
Phone # River Basin
Adj. Wtr. Body nat an /unkn�
Xiosest Maj. Wtr. Body �C-�'��
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s) -�
Finger pier(s) ;
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
_
I
I
�
Lj
i
Shoreline Length
SAV: not sure yes no
i
Sandbags: not sure yes no
Moratorium: n/a yes /-no
Photos: *.o
Waiver Attached: es --
A building permit may be required by: El See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
I
Issuing e % / f Expiration Date
I
Application Fee(s)
Check #
Local Planning Jurisdiction
Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

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uws; be act back a mvtimenn distarcc ; 7 S' Ica�7 aiy arc; of �:t rss unless
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ADJACENT RiJ'AR1XN PROPERTfi t?titiNER N"CMFJCATJU'4!WAl',ER
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Knipe 4f indi%lduat appl►ing for per►oit: '
Address of property
Jam K colo
f betey �ify that I aura pi:opaty adjacent to the above rc[aralCcd �4 individual gplyitrg for this permit has described to e P lwy 7U
dmwbw the de+,alopmcat the an . M, (4S shotrnt oa the a ached
iiimatssoas, Y pr i0$• A descrolioA of d Awi V, wirA
Id be provided with this Idler,
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Cn4 400 CAMMwed Ave., Murthead Citi, N� 285Sy or ra0 (� n dp&?60B N 0 V 6 ' ? GU 7
+within I9 days erf heeipt of this rtattie!• No redo is isrnmarredihtup* swan
�yoK Aare been n d by Crrgled Meie r@het G1
tY .DCM
wmftR SECTION
I tudcrstaad dtu a pie:, dock, mgoring pilings. bkt "atcr, boathouse, {ift or seadaw
mnst be act back a fAirnim= distance of 1s` fioa� mysu,ea ef'r'
0aw' by lam+ (if wish to weil*i tho setback, you must iaiti I tthe aPPt�Ne Wank
b�br►.�
`PL' I !a wish to waiv,t Vu 15' Wba
1 do��t wish to Waivo the I5' setback regttit ;rat
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